By Nancy RonesAs Ryan faces new and frightening setbacks in his struggle with autism, his
parents search for answers and find both purpose and peace in their new
For the past several months, REDBOOK has followed the Kalkowski family as it
grapples with the challenges of battling 3-year-old Ryan's autism. In our last
installment, Ryan's parents had a lot to celebrate: his birthday, his placement
in a preschool class for the upcoming fall that would include both typical
children and those...
One in 150 children is now affected with ASD, according to the CDC. Because
ASD is on a spectrum, many children are mildly affected, with less severe
symptoms. So the behaviors that typically point to ''classic" autism may
not be as pronounced or may be absent, says Paul Shattuck, PhD, an autism
researcher at Washington University in St. Louis.
Further complicating things, autism is often accompanied by other problems,
such as gastrointestinal ailments, hearing impairment, or behavior problems.
"Autism often comes with something else," Shattuck says.
The age at which ASD is diagnosed can vary greatly, says Shattuck. In some
children, he says, the disorder is apparent at 18 months. "You just
know," he says. With other children, the autism diagnosis may not be
confirmed until age 5 or so.
Parents can educate themselves about the typical symptoms, realizing that
not every child has all the same symptoms or the same severity of symptoms. In
general, children with ASD are socially impaired, may have language or
communication difficulties, and exhibit some unusual behaviors, such as
avoiding eye contact, resisting changes in routine, or declining to cuddle or
have other human contact.
Parents who pay careful attention and who know what to look for can become
aware of certain "red flags" that demand immediate professional
attention, even if they don't turn out to be ASD symptoms, according to the
American Academy of Pediatrics. Among them: the child arches his back instead
of snuggling when picked up; doesn't make much eye contact, or loses language
or social skills at any age.
Pay attention, too, to everyday interactions, Shattuck says. A toddler who
never wants to be held, for instance, is a warning sign and something to talk
to your pediatrician about as soon as possible. If language skills seem to be
lagging, that's a concern. A 15-month-old, for instance, should be able to say
single words; a 24-month-old should be able to say two-word phrases.
Your pediatrician should be on the lookout for any abnormal development
clues when you take your child in for well-baby visits.
Diagnosing ASD requires two steps, according to the CDC:
Developmental screening and surveillance during well-child visits to the
doctor. Screening tests to look for developmental disabilities and to be sure
your child has met developmental "milestones" such as talking and
walking are recommended at ages 9 months, 18 months, 24 months, and 30 months.
The screenings should be done routinely; if not, parents are advised to ask for
them during the well-child visits. The screening helps your child's
pediatrician identify possible developmental delays that might suggest autism
or such problems as language or thinking skill deficits. In recent years,
screening tools have been developed to better identify children not just with
classic autism but with milder forms of ASD, such as Asperger's syndrome. A
variety of standardized screening tools is available. Typically, they employ a
checklist or questionnaire format and have a cutoff "score."
A comprehensive evaluation, including observations by your pediatrician and
interviews with you as parents to find out more about your child's
developmental history. It should also include assessment of language and speech
and the use of one or more autism diagnostic tools. Among them are the Autism
Diagnosis Interview, the Childhood Autism Rating Scale, and The Gilliam Autism